Pediatric Health Care Providers Research Articles

Pediatric mTBI during the COVID-19 pandemic: considerations for evaluation and management

ABSTRACT The COVID-19 pandemic has changed healthcare utilization patterns and clinical practice, including pediatric mTBI evaluation and management. Providers treating pediatric mTBI, including neuropsychologists, have a unique role in evaluating and managing an already complex injury in the context of the COVID-19 pandemic with limited empirically based guidelines. In the present paper, we review usual, evidence-based pediatric mTBI care, highlight changes experienced by healthcare providers since the onset of the pandemic, and provide possible considerations and solutions. Three primary challenges to usual care are discussed, including changes to post-injury evaluation, management, and treatment of persistent symptoms. Changing patterns of healthcare utilization have created unique differences in mTBI identification and evaluation, including shifting injury frequency and mechanism, reluctance to seek healthcare, and increasing access to telemedicine. Typical injury management has been compromised by limited access to usual systems/activities (i.e., school, sports, social/leisure activities). Patients may be at higher risk for prolonged recovery due to pre-injury baseline elevations in acute and chronic stressors and reduced access to rehabilitative services targeting persistent symptoms. Considerations and solutions for addressing each of the three challenges are discussed. Neuropsychologists and other pediatric healthcare providers will need to continue to flexibly adapt to the changing needs of youth recovering from mTBI through the duration of the pandemic and beyond. Consistent with pre-pandemic consensus statements, neuropsychologists remain uniquely qualified to evaluate and manage mTBI and provide an increasingly integral role as members of multidisciplinary teams in the context of the global pandemic. Abbreviations: AAP: American Academy of Pediatrics; CDC: Centers for Disease Control and Prevention; COVID-19: coronavirus disease 19; ED: emergency department; mTBI: Mild traumatic brain injury.

Parents' Intentions and Perceptions About COVID-19 Vaccination for Their Children: Results From a National Survey.

Assess the degree to which US parents are likely to have their children get coronavirus disease 2019 (COVID-19) vaccines and identify parental concerns about the vaccines. In February 2021 to March 2021, we surveyed parent members of a nationally representative probability-based Internet panel of ∼9000 adults regarding their intent to have their children receive a COVID-19 vaccination, perceptions of COVID-19 vaccines for children, and trust in sources of information about COVID-19 vaccines for children. We used descriptive and multivariate analyses to evaluate parent-stated likelihood of having their children get a COVID-19 vaccine and to assess the association between likelihood of child COVID-19 vaccination and child age, parent demographics, and parental perceptions about COVID-19 vaccines. Altogether, 1745 parents responded (87% of eligible parents, 3759 children). Likelihood of child COVID-19 vaccination was as follows: very likely (28%), somewhat likely (18%), somewhat unlikely (9%), very unlikely (33%), and unsure (12%). The stated likelihood of child vaccination was greater among parents of older children (P < .001) as well as among parents who had a bachelor's degree or higher education (P < .001), had already received or were likely to receive a COVID-19 vaccine (P < .001), or had Democratic affiliation (P < .001); variations existed by race and ethnicity (P = .04). Parental concerns centered around vaccine safety and side effects. A key trusted source of information about COVID-19 vaccines for children was the child's doctor. Less than one-half of US participants report that they are likely to have their child receive a COVID-19 vaccine. Pediatric health care providers have a major role in promoting and giving COVID-19 vaccination for children.

Investigating a “Wait and See” Mindset Among Pediatric Health Care Providers

In the United States, there is a widespread concern with not referring more infants and toddlers with a risk of or identified autism spectrum disorder (ASD) to Early Intervention (EI) under Part C of the Individuals with Disabilities Education Act (IDEA, 2004). Despite early signs and screening initiatives, most children with ASD are not referred for services covered by IDEA until after the age of 4 years. To explore the prevalence of and factors correlated with a potential “wait and see” mindset among one group of stakeholders influencing referral decisions, we disseminated an expert-reviewed survey to pediatric health care providers in a southeastern metro area (n = 99). They self-reported views on waiting to refer, perceived roadblocks to screening and referral, and viable recommendations. Most participants reported using a “wait and evaluate further” approach instead of “wait and see,” and the large majority were not very comfortable discussing suspected ASD with parents of young children (birth to 5 years of age). Those with more years of experience reported being less likely to wait to refer an infant/toddler and more comfortable speaking with parents about suspected signs of ASD. We discuss findings and implications for a comprehensive, multisector approach to outreach and referral.

The Importance of Skincare for Neonates and Infants: An Algorithm.

The skin of neonates and infants undergoes a maturation process from birth and is susceptible to barrier disruption. The current algorithm follows a US-based consensus paper on skincare approaches using gentle cleansers and moisturizers in neonatal and healthy infant skin. This summary provides clinical information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants. The project used a modified Delphi process comprising virtual discussions followed by an online follow-up replacing the use of a questionnaire. During the virtual meeting, the systematic literature review results and a draft algorithm addressing over-the-counter skincare for neonates and infants with healthy skin were discussed and adopted using evidence coupled with the expert opinion and experience of the panel. The algorithm addresses three clinical signs: xerosis, erythema, and erosion/bulla. A growing body of evidence recognizes the benefits of ongoing daily use of non-alkaline cleansers and ceramides containing moisturizers to reduce inflammation and maintain a healthy skin barrier function. Diaper rash is common in infants presenting as erythema or, in more severe cases, skin erosion. Skin protection with a barrier cream and frequent diaper changes using disposable diapers resolves most cases; however, if the rash continuous despite appropriate care, rule out a candida infection. The current algorithm focuses on neonatal and infant healthy skin that can benefit from skincare. When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier. J Drugs Dermatol. 2021;20(11):1195-1205. doi:10.36849/JDD.6219.

Doing the Right Thing: Aligning Plans With Goals and Values for Pediatric Patients.

Doing the Right Thing: Aligning Plans With Goals and Values for Pediatric Patients.

A Human Trafficking Educational Program and Point-of-Care Reference Tool for Pediatric Residents.

IntroductionTrafficked youth experience complex health issues such as substance abuse, severe physical trauma, and sexual health problems, with many entering trafficking between 15 and 17 years old. There is increasing awareness of the need to educate pediatric health care providers on identifying and aiding trafficked children; however, critical gaps in the literature exist regarding educational sessions specific to the human trafficking of pediatric patients. Our objective was to implement and evaluate a survivor-informed educational session for pediatric resident physicians to improve identification of and assistance to trafficked youth in the clinical setting.MethodsWe designed an educational session on human trafficking, which included a 60-minute interactive didactic presentation and distribution of a point-of-care reference tool, in collaboration with a survivor of human trafficking, for 59 pediatric trainees in 2019. We utilized pre/post knowledge assessments. Data analysis included descriptive statistics and Fisher exact analysis.ResultsOf 99 total eligible residents, 59 (59%) participated. Statistically significant increases in correct identification of hypothetical trafficked youth and next steps for intervention were observed. Over 80% of participants reported comfort with defining, recognizing, referring to, and understanding health consequences of human trafficking on the postassessment, compared to 25% on the preassessment (p < .001).DiscussionOur educational session resulted in statistically significant increased comfort in identification of human trafficking victims and can be replicated at other institutions. The point-of-care reference tool—which can be adapted for use in different settings—can guide pediatric residents in managing suspected trafficked youth in the clinical setting.

Interim Federal Health Program: Survey of access and utilization by paediatric health care providers.

The Interim Federal Health Program (IFHP) provides health care coverage to refugees and refugee claimants, yet remains underused by providers. The objective of this study was to assess Canadian paediatricians' current understanding and utilization of the IFHP, and perceived barriers to utilization. A one-time survey was administered via the Canadian Paediatric Surveillance Program in February 2020. In addition to descriptive statistics, multinomial logistic regressions were built to examine paediatrician use of the IFHP, and characteristics associated with registration and use. Of the 2,753 physicians surveyed, there were 1,006 respondents (general paediatricians and subspecialists). 52.2% of respondents had provided care to IFHP-eligible patients in the previous 6 months. Of those participants, only 26.4% were registered IFHP providers, and just 16% could identify 80% or more of IFHP-covered services. Knowledge of 80% or more of IFHP-covered services was associated with registration status (adjusted odds ratio [aOR] 1.92; 95%CI 1.09 to 3.37). Among those who knew they were not registered, 70.2% indicated they did not know they had to register. aOR demonstrated that those with fewer years of practice had higher odds of not knowing that they had to register (aOR 1.22; 95%CI 1.01 to 1.49). We demonstrate that IFHP is poorly utilized by paediatric providers, with low registration rates and poor understanding of IFHP-covered supplemental services, even among those who have recently provided care to IFHP-eligible patients. Efforts to improve registration and knowledge of IFHP are essential to improving access to health care for refugee children and youth.

The Role of Pediatric Health-care Providers in Promoting Students' Asthma Health.

The Role of Pediatric Health-care Providers in Promoting Students' Asthma Health.

Pediatric Readiness for Hospital Discharge Scale (PedsRHDS): Use in Interdisciplinary Caregiver Training Program in Acute Inpatient Rehabilitation

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Hospital discharge readiness is an important yet often elusive matter for pediatric patients, families, and health care providers. Caregiver readiness for discharge should be assessed both at admission and before discharge to allow for timely education and training. The Pediatric Readiness for Hospital Discharge Scale is recommended for use by OTs in an acute rehabilitation setting because they harness the unique ability to address both physical and psychosocial aspects of the child and family encompassed by the measure. Primary Author and Speaker: Lori B. Ragni Additional Authors and Speakers: Camille Velasco, Teresa Fitzsimons, and Katie Shniderman

Human Papillomavirus Vaccination Knowledge, Barriers, and Recommendations Among Healthcare Provider Groups in the Western United States.

This study compared human papillomavirus (HPV) vaccination occurrences on the same day as provider recommendations at clinics in the Western United States stratified by healthcare provider groups. In addition, the relationships between provider groups' perceived challenges associated with HPV vaccination, HPV vaccination knowledge, HPV recommendation practices, and same-day HPV vaccinations and recommendations are described. Eligible participants included pediatric healthcare providers and staff with influence on patient/parental-level decisions regarding HPV vaccination. Participants filled out a 40-question survey. Results for study participants (N = 99) showed providers reported a higher number of challenges limiting HPV vaccination, higher HPV vaccination knowledge, and more favorable HPV vaccination recommendation practices compared to other healthcare team members (OTM) suggesting providers may have a better overall understanding of the HPV vaccination climate than OTMs. Clinics should examine OTMs' training, expectations, and opportunities to increase the frequency and strength of HPV vaccination recommendations to adolescent patients and parents.

Promoting Healthy Sexuality for Children and Adolescents With Disabilities.

This clinical report updates a 2006 report from the American Academy of Pediatrics titled "Sexuality of Children and Adolescents With Developmental Disabilities." The development of a healthy sexuality best occurs through appropriate education, absence of coercion and violence, and developmental acquisition of skills to navigate feelings, desires, relationships, and social pressures. Pediatric health care providers are important resources for anticipatory guidance and education for all children and youth as they understand their changing bodies, feelings, and behaviors. Yet, youth with disabilities and their families report inadequate education and guidance from pediatricians regarding sexual health development. In the decade since the original clinical report was published, there have been many advancements in the understanding and care of children and youth with disabilities, in part because of an increased prevalence and breadth of autism spectrum disorder as well as an increased longevity of individuals with medically complex and severely disabling conditions. During this same time frame, sexual education in US public schools has diminished, and there is emerging evidence that the attitudes and beliefs of all youth (with and without disability) about sex and sexuality are being formed through media rather than formal education or parent and/or health care provider sources. This report aims to provide the pediatric health care provider with resources and tools for clinical practice to address the sexual development of children and youth with disabilities. The report emphasizes strategies to promote competence in achieving a healthy sexuality regardless of physical, cognitive, or socioemotional limitations.

Age and reasons for first dental visit in a tertiary care hospital in South India

Background: Early visit to the dentist with an aim of prevention has been advocated universally, but the timing for seeking dental treatment differs among different countries. Aim: This study aimed to determine the timing and reasons for the first dental visit among children attending the dental clinic in a tertiary care hospital in Tamil Nadu, South India. Methods: This hospital-based study reviewed the dental records of children who had visited the dental clinic from January 1, 2019 to December 31, 2019. All those between 0 and 10 years of age and visiting a dentist for the first time were included in the study. The continuous variables were analyzed using mean and standard deviation. The categorical variables were calculated using Chi-square, Fisher's exact test, and two-proportion test. Results: We reviewed the dental records of 1005 children (60% boys and 40% girls). The most frequent age for the first dental visit was between 5 and 6 years. The most common reasons for visits to the dental clinic were pain (23.8%) and dental caries (16.6%). Only 3.8% of children had their first dental visit by 1 year of age and primarily for therapeutic purposes. Dental caries and traumatic injuries were more frequent in children below the age of 3 years. Conclusion: The present study found pain as the most frequent reason for the visit, but there was a delay in first dental visits among children. This study suggests effective oral health policies for children and a need to change the perception and practices among the dental professionals in the region. Timing of the first dental visit of a child can help us to determine the quality of dental care a child receives. Delayed dental visit among children in this study indicates the ineffective oral health policies and the gap that exists between the pediatric health-care providers in India.

Pediatric HEALTHCARE Provider Awareness, Confidence, and Use of Sports Specialization Recommendations and Application towards Youth Athlete Counseling

Background:Sport specialization is increasingly common in many youth sports and has been linked to increased injury, overtraining, and burnout. Several organizations have developed safe sport recommendations in an effort to mitigate injury risk. Healthcare providers (HCPs) can be a source of education for parents and athletes on safe sports practices, but the awareness, confidence, and use of these recommendations among HCPs who work with youth athletes is limited. Hypothesis/Purpose: To evaluate the awareness, confidence, and use of sports specialization and safe sport recommendations of HCPs who work with pediatric athletes.Methods:A cross-sectional online survey was developed to assess pediatric HCP awareness of, confidence in, and clinical use of sports specialization recommendations. The survey included 1) personal demographics, 2) professional demographics, 3) knowledge and perceptions of sport specialization, 4) awareness, confidence, and use of recommendations, and 5) HCP program training and professional development background specific to sports specialization. Survey links were sent by email to 5000 secondary school athletic trainers and 297 PRiSM members during October 2019-January 2020. The survey was open for 4 weeks, with a reminder email sent after 2 weeks. Data was analyzed with descriptive statistics.Results:The survey was accessed by 620 HCPs (access rate=11.7%) and completed by 508 HCPs (completion rate=81.9%). Respondents (279 females, 228 males; age=37.2±10.5 years) included athletic trainers (74.5%, n=379), physicians (16.9%, n=86, physical therapists (6.7%, n=35), nurse practitioners (1.0%, n=5), and physician assistants (0.1%, n=4) with 11.2±9.1 years of experience providing care to pediatric athletes. Three-fourths of respondents (n=373) were aware of recommendations from the National Athletic Trainers’ Association, but fewer were aware of those from the American Academic of Pediatrics (42.3%, n=212), American Medical Society for Sports Medicine (40.3%, n=200), American Orthopaedic Society for Sports Medicine (45.2%, n=225), International Olympic Committee (14.2%, n=69), Major League Baseball (30.6%, n=151), USA Hockey (13.6%, n=66), and National Basketball League (9.3%, n=45). The percentage of respondents who were confident in knowledge of (Table 1) and used (Table 2) each organization’s recommendation are provided in the tables. Table 3 presents the degree to which various reasons limit the use of sports specialization recommendations.Conclusion:Healthcare providers are aware of sport specialization recommendations and believe they are associated with decreased risk of injury. However, barriers to applying the recommendations most cited were the inability of parents and children to change specialization behaviors. Future research should focus on implementation of recommendations to enact behavior change.Tables

What Lies Ahead for Young Hearts in the 21st Century - Is It Double Trouble of Acute Rheumatic Fever and Kawasaki Disease in Developing Countries?

Rheumatic heart disease (RHD), the principal long-term sequel of acute rheumatic fever (ARF), has been a major contributor to cardiac-related mortality in general population, especially in developing countries. With improvement in health and sanitation facilities across the globe, there has been almost a 50% reduction in mortality rate due to RHD over the last 25 years. However, recent estimates suggest that RHD still results in more than 300,000 deaths annually. In India alone, more than 100,000 deaths occur due to RHD every year (Watkins DA et al., N Engl J Med, 2017). Children and adolescents (aged below 15 years) constitute at least one-fourth of the total population in India. Besides, ARF is, for the most part, a pediatric disorder. The pediatric population, therefore, requires special consideration in developing countries to reduce the burden of RHD. In the developed world, Kawasaki disease (KD) has emerged as the most important cause of acquired heart disease in children. Mirroring global trends over the past two decades, India also has witnessed a surge in the number of cases of KD. Similarly, many regions across the globe classified as “high-risk” for ARF have witnessed an increasing trend in the incidence of KD. This translates to a double challenge faced by pediatric health care providers in improving cardiac outcomes of children affected with ARF or KD. We highlight this predicament by reviewing the incidence trends of ARF and KD over the last 50 years in ARF “high-risk” regions.

Evaluating the Feasibility of Continuing Medical Education for Disseminating Emerging Science on the Breast Cancer and Environment Connection

Developing continuing medical education (CME) training programs is a strategy for communicating emerging science to health practitioners. This research tests the feasibility of using CME modules for translating and disseminating research findings from the Breast Cancer and Environment Research Program. Recent findings have identified certain windows of susceptibility, like during puberty, in which exposure to endocrine-disrupting chemicals can increase breast cancer risk later in life. In order to reach pediatric patients and their caregivers, using a Diffusion of Innovations framework, pediatric health-care providers were identified as opinion leaders. Two CME modules informed by theory and formative research were tested with a sample of pediatricians and pediatric nurse practitioners. Participants completed knowledge, attitude, intention, and behavior items immediately before and after exposure to a randomly assigned module, and then again 3 weeks later. Quantitative and qualitative results indicate knowledge gain and strong links between practitioners’ intentions to enact and implemented behavior learned from training recommendations with parents and caregivers in their practices. Results indicate that CMEs can be an effective strategy for translational activities targeted to health providers in order to change behavior within practice.

A global child health perspective on climate change, migration and human rights

Current indicators of anthropogenic climate change are foreboding and demand immediate collaborative action and policy change to reduce carbon emissions rapidly. Human and environmental effects of climate change are already widespread. Large-scale disruptive disasters and weather-related events have downstream and cascading effects on livelihoods, national economies, population health and global human rights. These effects create human displacement and migration crises with far-reaching implications for children. Displacement and migration, both within and across national borders, have sequelae for the physical and mental health of children. Young children are vulnerable-both physiologically and developmentally immature-and dependent on others for safety and resources. They also are least responsible for the climate crisis. Child health threats stemming from displacement and migration exemplify questions of social and intergenerational injustice inherent in the climate crisis. Pediatric health care providers are increasingly called upon to care for children and ensure access to care for children who have experienced displacement from climate change, even as dire predictions for the future are escalating climate adaptation efforts. Pediatric health care providers have a role in these efforts-to identify and advocate for those children most at risk from climate change and to bolster clinical care and education strategies to prevent harm to our patients and children. This paper provides a global perspective on climate change for pediatric providers, including how climate change reflects and reinforces colonial legacies that harm child health. We provide action steps for those providers who care for children who have been displaced in the U.S. and who advocate for children's health globally.

A Combined Reach Out and Read and Imagination Library Program on Kindergarten Readiness.

Sharing books with preschoolers is known to improve kindergarten readiness. Both Reach Out and Read (ROR) and Dolly Parton's Imagination Library (DPIL) have shown positive effects on book sharing at home. We developed a novel combined ROR/DPIL program and examined the effect on kindergarten readiness assessment (KRA) scores. At urban ROR primary care sites, patients <5 years living in the city school district were enrolled from July 2015 through January 2019 in the ROR/DPIL program when seen for a clinic visit. The literacy subtest of the KRA was examined for participants entering kindergarten in the fall of 2016, 2017, and 2018. The "on-track" rate of participants was compared with nonparticipant groups. A total of 797 kindergarten-aged ROR/DPIL participants were matched to Ohio KRA scores for 2016, 2017, and 2018 school years. The percentages of students "on-track" on KRA literacy subtests increased significantly by cohort (2016, 42.9% [95% confidence interval (CI): 34.9%-50.9%] versus 2017, 50.9% [95% CI: 44.9%-56.9%] versus 2018, 58.3% [95% CI: 53.3%-63.3%], P = .004). ROR/DPIL participants were compared with a proportionate stratified random sample of 1580 non-ROR/DPIL peers. On-track in literacy did not significantly differ between groups (2016 [P = .262], 2017 [P = .653], 2018 [P = .656]), nor did they differ after restricting analysis to economically disadvantaged children (2016 [P = .191], 2017 [P = .721], 2018 [P = .191]). With these results, we suggest that a program combining literacy anticipatory guidance at clinic visits and more books in the home can potentially improve kindergarten readiness. Pediatric health care providers can play an important role in promoting kindergarten readiness through literacy promotion.

569-P: Fear of Nighttime Hypoglycemia: Diabetes Providers Recognize Parents’ Concerns

Objective: Pediatric diabetes healthcare providers and parents of youth with type 1 diabetes (T1D) described specific fears regarding nighttime hypoglycemia and behaviors parents engage in at night to avoid nighttime lows (i.e., blood glucose &amp;lt; 70mg/dL). Methods: We completed semi-structured interviews with 10 diabetes providers (i.e., physicians, nurses, educators) and 15 parents of youth with T1D (Mean parent age= 41.92 ± 5.72 years, Mean child age= 10.96 ± 2.37 years). All children used a continuous glucose monitor and 87% used an insulin pump. Providers described the fears and behaviors parents express in clinic related to their child’s overnight glucose management. Parents described their own fears and behaviors specific to nighttime lows. We transcribed interviews verbatim, and used Framework Matrix Analysis to identify common themes among responses. Results: Provider and parent interviews converged on several main themes (provider percentages first, parent percentages second). Regarding specific fears, consensus among participants indicated that parents fear overnight lows will harm their child (i.e., death, seizures; 90%, 87%), parents worry they will not hear alarms or wake up to help their child at night (50%, 93%), and parents fear devices will malfunction at night (20%, 67%). Regarding avoidance behaviors, participants reported that parents provide snacks at bedtime to raise glucose levels (70%, 60%), parents set temporary (lower) basal levels (40%, 53%), under-correct at night 20%, 46%), set multiple alarms to wake up during the night to check on their child (80%, 87%), and do not allow their child to attend sleepovers (30%, 80%). Conclusions: We identified several common fears and avoidance behaviors that may be specific to overnight lows in parents of youth with T1D. As a next step, we will use our qualitative data to inform a new tool to specifically assess parental fear of nighttime hypoglycemia, which will fill a current gap in both research and clinical care for youth with T1D. Disclosure A. Monzon: None. R. Mcdonough: None. C. C. Cushing: None. M. A. Clements: Consultant; Self; Eli Lilly and Company, Employee; Self; Glooko, Inc., Research Support; Self; Abbott Diabetes, Dexcom, Inc. S. R. Patton: None.

Pediatric Mental Healthcare Providers’ Perceptions of the Delivery of Partial Hospitalization and Outpatient Services via Telehealth during the COVID-19 Pandemic

ABSTRACT The COVID-19 pandemic has required healthcare providers to deliver services via telehealth. Unfortunately, many mental healthcare providers have not received direct training in telehealth delivery. Recent research suggests that this disconnect between the large-scale and rapid transition to telehealth service delivery required by the pandemic, combined with inadequate training or preparation time, may result in challenges to delivering quality clinical care. The current study presents results of an online questionnaire completed by 44 pediatric mental healthcare providers assessing provider perspectives of the experience of delivering services during the COVID-19 pandemic. Providers included psychiatrists, psychologists, social workers, licensed professional counselors, and direct-care staff. Services were delivered in three different partial hospitalization programs and in a general outpatient clinic at a children’s hospital associated with an academic medical center. Results showed moderate acceptability of telehealth, overall, and a clear preference for at least having a portion of visits be in-person as opposed to solely via telehealth. Provider satisfaction with telehealth delivery and perceptions of quality of clinical care appeared to differ among services. We discuss the implications of these data to inform healthcare settings delivering mental health services via telehealth.

Compassion in pediatric oncology: A patient, parent and healthcare provider empirical model.

ObjectiveCompassion has long been considered a cornerstone of quality pediatric healthcare by patients, parents, healthcare providers and systems leaders. However, little dedicated research on the nature, components and delivery of compassion in pediatric settings has been conducted. This study aimed to define and develop a patient, parent, and healthcare provider informed empirical model of compassion in pediatric oncology in order to begin to delineate the key qualities, skills and behaviors of compassion within pediatric healthcare.MethodsData was collected via semi‐structured interviews with pediatric oncology patients (n = 33), parents (n = 16) and healthcare providers (n = 17) from 4 Canadian academic medical centers and was analyzed in accordance with Straussian Grounded Theory.ResultsFour domains and 13 related themes were identified, generating the Pediatric Compassion Model, that depicts the dimensions of compassion and their relationship to one another. A collective definition of compassion was generated–a beneficent response that seeks to address the suffering and needs of a person and their family through relational understanding, shared humanity, and action.ConclusionsA patient, parent, and healthcare provider informed empirical pediatric model of compassion was generated from this study providing insight into compassion from both those who experience it and those who express it. Future research on compassion in pediatric oncology and healthcare should focus on barriers and facilitators of compassion, measure development, and intervention research aimed at equipping healthcare providers and system leaders with tools and training aimed at improving it.